| Guillermo Somodevilla Md Pa | |
|
7805 Coral Way #126 Miami FL 33155-6539 | |
| (305) 269-0385 | |
| (305) 269-0386 |
| Full Name | Guillermo Somodevilla Md Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 7805 Coral Way, Miami, Florida |
| Authorized Official Name and Position | Guillermo Somodevilla (PRESIDENT) |
| Authorized Official Contact | 3052690385 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guillermo Somodevilla Md Pa 7805 Coral Way #126 Miami FL 33155-6539 Ph: (305) 269-0385 | Guillermo Somodevilla Md Pa 7805 Coral Way #126 Miami FL 33155-6539 Ph: (305) 269-0385 |
| NPI Number | 1679749998 |
|---|---|
| Provider Enumeration Date | 05/06/2008 |
| Last Update Date | 05/06/2008 |
| Medicare PECOS PAC ID | 2264625813 |
|---|---|
| Medicare Enrollment ID | O20101015000298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679749998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME0049294 (Florida) | Primary |
| Provider Name | Guillermo Somodevilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124113782 PECOS PAC ID: 9931288867 Enrollment ID: I20101207000657 |
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